Diabetes Gestacional: asociación con grupo ABO / Association of abo blood groups with gestational diabetes mellitus

Background: ABO and Rhesus blood systems are associated with type 2 Diabetes Mellitus (DM2). Gestational Diabetes (GDM) is a model to study DM. Aim: To study the association between GDM and ABO and Rhesus groups. Material and Methods: A retrospective cohort study was performed in 1,078 women who gave birth to a singleton in Talca Regional Hospital, Chile, during 2008. We analyzed personal, obstetric, medical data and ABO and Rh blood groups. Results: GDM was diagnosed in 6.6% of women. Age and body mass index were significantly associated with GDM. There were no differences in Rh blood groups (p = 0.604), while ABO groups were different between GDM and controls. B antigen was present in 3% of GDM women and in 10.8% of controls (p = 0.037), with an odds ratio of 0.25 after adjusting for other associated risk factors (p = 0.06). Conclusions: ABO group is suggested as a possible protector marker for GDM.

Leucemia eosinofílica crónica con respuesta hematológica sostenida tras tratamiento con bajas dosis de imatinib / Sustained hematologic response in chronic eosinophilic leukemia with low dose imatinib. Report of one case

We report a 58 year-old-man without comorbid conditions, with a history of two months of weight loss, malaise and headache. His initial laboratory analysis showed leukocytosis of 16,100/mL with 65% eosinophils and an absolute eosinophil count of 10,465/mL. Both bone marrow biopsy and aspirate showed infiltration by mature appearing eosinophils. Treatment was started with hydroxyurea, associated with prednisone without satisfactory decrease in the eosinophil count. Polymerase chain reaction showed the presence of the gene fusion product FIP1L1/PDGFRA. Imatinib therapy was initiated, resulting in a rapid and progressive reduction in the absolute eosinophil count, with normalization at the second week of treatment. The incidence of the myeloproliferative variant causing hypereosinophilic syndrome is rare. However, the dramatic response to imatinib emphasizes the need to study the presence of the fusion product FIP1L1/PDGFRA in all patients with eosinophilia of unknown etiology.

Perfil epidemiológico y características generales de las víctimas de atentados sexuales en el hospital de San Javier / Epidemiological profile and general characteristics victims of sexual assault in the Hospital San Javier

Sex crimes break the people’s sexual self-determination and minor` sexual indemnity. They do not only relate to physical force, but involve different types of sexual violence. We made a descriptive review of all cases observed in the emergency room of San Javier’s hospital from January 2009 to December2011.Records of the emergency department and the standard questionnaire delivered by the legal medical service to all health centers, were analyzed. Eighty-four percent were female,58 percent under 18 years-old, 76 percent single, 50 percent students and 52 percent had urban residence. In half of the cases were reported to the police, rape was the most reported attack with52 percent and percent of complaints were originated from a single event. Was obtained 36 percent of normal physical examinations. The most frequent lesions were extragenital, followed by genital and coloproctologic. Sixty-four percent of the offenderswere known by the victim; in 36 percent of cases the perpetrator was a relative and 6 percent of them was the father of the victim. We conclude that women are the main victims of sexual assaults,mainly children, singles and students. We recommenda systematic review of such complaints.

Insuficiencia renal aguda secundaria como manifestación inicial de favismo en un adulto mayor: Caso clínico / Favism presenting as an acute renal failure: Report of one case

Background: We report a 67-year-old man presenting with abdominal pain of acute onset, pallor, jaundice and behavioral changes after ingestion of fava beans. In the initial evaluation he appeared acutely ill and had resting dyspnea, edema and jaundice. His initial laboratory assessment disclosed azotemia, elevated lactate dehydrogenase levels, a low hemoglobin concentration (4.9 /dL) and a high corrected reticulocyte count (4,7%) with negative direct and indirect Coombs' test. The patient was transferred to the ICU, where he received support therapy with hemodialysis, mechanical ventilation, vasoactive drugs and transfusions of packed red cells. The evolution after 1 month was favorable and he was discharged without anemia and with normal renal function. Three months after discharge, the glucose-6-phosphate-dehydrogenase screening study did not demonstrate detectable enzymatic activity.

Linfoma esplénico de zona marginal como causa de esplenomegalia masiva: reporte de caso clínico y revisión de la literatura / Splenic marginal zone lymphoma as cause for massive splenomegaly: a clinical case and literature review

Massive splenomegaly is in the which the growth of the spleen has spread to other quadrants of the abdomen. It is produced by a limited number of pathologies, both benign and malignant. It is presented a case of a 62 year-old woman who is consulting for four years of progressive increase in her abdominal volume, associated to the feeling of abdominal fullness, dyspnea on moderate exertion and lower extremities edema. At the physical examination was observed massive splenomegaly and jaundice. The hemogram showed pancytopenia and a lymphocyte count of80 percent. The myelogram revealed marrow infiltration by lymphocytes of mature appearance. Flow cytometry of peripheral blood showed 70 percent of lymphocytes, which expressed B cells markers CD19, CD20, CD23and FMC7 in addition to Kappa light chain restriction, suggesting marginal splenic zone lymphoma. The bone marrow biopsy showed lymphoid small cells infiltrate with positive markers CD20, CD5,CD23 and negative cyclin D1 study. BCL-2 was also positive. It was considered unfit to receive chemotherapy and was treated with 4 cycles of rituximab, with significant decrease of splenic size.